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Treatment Results of Reamed Exchange Nailing in Aseptic Nonunion of Tibial Shaft Fracture
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Yongjin Cho, Jun Young Lee, Jehong Ryu, Hyoung Tae Kim, Jong Jin Moon
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J Korean Fract Soc 2023;36(4):125-132. Published online October 31, 2023
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DOI: https://doi.org/10.12671/jkfs.2023.36.4.125
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 Abstract
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- Purpose
Intramedullary nailing is used widely for treating tibial diaphysis fractures because of its relatively rigid internal fixation, which allows weight bearing, resulting in rapid bone healing and functional recovery. This study evaluated the results of exchange nailing in treating aseptic nonunion of tibial shaft fractures.
Materials and Methods
From November 2015 to December 2021, a retrospective study was conducted on patients who had undergone intramedullary nailing for tibial diaphysis fractures. Among them, this study focused on patients diagnosed with nonunion and who underwent exchange nailing. Twenty patients with a minimum follow-up period of at least 12 months were included in the study.
Results
The mean ages of patients were 60 years (range, 30-79 years). Of the 20 cases in which exchange nailing was performed, bone union was achieved in 18 cases (90.0%), and the mean period was 23 weeks (range, 14-46 weeks). Among the 18 cases of bone union, one case exhibited delayed union and achieved union without additional treatment after 46 weeks, while two cases of nonunion failed to achieve union and were lost to follow-up until the final assessment.
Conclusion
Reamed exchange nailing performed on aseptic nonunion after intramedullary nailing for tibial diaphysis fractures had satisfactory clinical outcomes.
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Results of Intramedullary Nailing for Distal Metaphyseal Intra-Articular Fractures of Tibia
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Jun Young Lee, Yongjin Cho, Hyung Seok Park, Se Woong Jang
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J Korean Fract Soc 2020;33(4):196-203. Published online October 31, 2020
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DOI: https://doi.org/10.12671/jkfs.2020.33.4.196
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Abstract
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- Purpose
This study examined the results of internal fixation using an intramedullary nail in the treatment of distal metaphyseal fractures involving the articular surface.
Materials and Methods
From November 2009 to November 2018, distal tibia fractures involving the articular surface were treated with intramedullary nailing only for fractures corresponding to AO type 43 B and 43 C1, twenty-four cases were studied retrospectively. The tibial alignment was measured preoperatively and postoperatively, and the bone union time and nonunion were assessed. In addition, the clinical evaluation of ankle joint function was assessed using the Olerud and Molander ankle score (OMAS).
Results
Complete bone union was obtained in all cases, and the mean union time was 17.7±1.87 weeks (range, 15-20 weeks). The average preoperative coronal alignment was 6.4°±1.0° (range, 5.2°-8.4°), and sagittal alignment was 2.7°±0.6° (range, 1.9°-3.8°). The average postoperative coronal alignment was 2.5°±0.13° (range, 2.2°-2.6°) and sagittal alignment was 0.4°±0.25° (range, 0.09°-0.95°). There was no nonunion. The OMAS had an average of 85±7.9 points (range, 70-95 points).
Conclusion
In the treatment of distal metaphyseal fractures involving the articular surface, internal fixation using an intramedullary nail reduces complications and achieves satisfactory reduction and union.
This method is considered an excellent treatment to obtain good clinical results.
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